MR. BRIAN THOMAS EDMONDSON (LCSW) – Clinical Social Worker, NPI 1407020555

MR. BRIAN THOMAS EDMONDSON (LCSW) is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 3549 (OK). The NPI Number for MR. BRIAN THOMAS EDMONDSON (LCSW) is 1407020555

Main info

Male
Sole Proprietor
38 Years Of Experience
Accepts Medicare Assignment
Name
MR. BRIAN THOMAS EDMONDSON (LCSW)
NPI
1407020555
Phone
(405) 843-1551
Address
5009 N PENNSYLVANIA AVE
Enumeration Date
19 April 2008
Last Update Date
19 April 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4058431551
Graduation Year
1988 (38 years ago)
PAC ID
0547320020
Group Practice PAC ID
6800946831
Professional Enrollment ID
I20081114000253
Address ID
OK731169037OK6801XEXTX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

628 CLINICAL SOCIAL WORKER in OK

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Provider Addresses for MR. BRIAN THOMAS EDMONDSON (LCSW)

  • North Pennsylvania Avenue, Oklahoma City, Oklahoma County, Oklahoma, 73107, United States

    SUITE 116

    OKLAHOMA CITY, OK 731128888

    Phone: (405) 843-1551

    Fax: (405) 843-1494

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-11-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081114000253IClinical Social WorkerOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73112)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800946831View full group profile
NameSpecialtyState
Clinical Social WorkerOK
Clinical Social WorkerOK
Clinical PsychologistOK

Reviews

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Frequently asked questions

What NPI should I save for MR. BRIAN THOMAS EDMONDSON (LCSW)?
Save NPI 1407020555 if you need a stable reference for MR. BRIAN THOMAS EDMONDSON (LCSW).
Does this profile mean MR. BRIAN THOMAS EDMONDSON (LCSW) is currently active?
Yes — MR. BRIAN THOMAS EDMONDSON (LCSW) appears active in the national provider directory.
Can you summarize MR. BRIAN THOMAS EDMONDSON (LCSW)'s specialty in plain language?
Clinically, the directory lists MR. BRIAN THOMAS EDMONDSON (LCSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location metadata exists for MR. BRIAN THOMAS EDMONDSON (LCSW)?
The page summarizes Oklahoma City, Oklahoma for MR. BRIAN THOMAS EDMONDSON (LCSW); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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